The present disclosure relates to osteochondral implants or plugs and, more particularly, to a surgical apparatus and method for manipulating one or more osteochondral plugs, including, but not limited to, extracting and/or impacting the one or more osteochondral plugs.
Osteochondral plugs may be extracted from, and/or impacted into, various locations in the human body. For example, one or more osteochondral plugs may be impacted into the knee of the human body. More particularly, in the human body, the knee consists of three bones—a femur, a tibia, and a patella—that are held in place by various ligaments. The chondral surfaces of the femur and the tibia form a hinge joint, and the patella protects the joint. Portions of the chondral surfaces of the femur and the tibia, as well as the underside of the patella, are covered with an articular cartilage which allow the femur and the tibia to smoothly glide against each other without causing damage. A menicus sits between the articular cartilage and the bone to distribute weight and to improve the stability of the joint. The articular cartilage often tears, usually due to traumatic injury (often seen in athletics) and degenerative processes (seen in older patients). This tearing does not heal well due to the lack of nerves, blood vessels and lymphatic systems and the resultant knee pain and swelling and limited motion of the bone(s) and must be addressed.
Damaged adult cartilage has historically been treated by a variety of surgical interventions including lavage, arthroscopic debridement, and repair stimulation, all of which provide less than optimum results. Another known treatment involves removal and replacement of the damaged cartilage with a prosthetic device. However, the known artificial prostheses have largely been unsuccessful since they are deficient in the elastic, and therefore in the shock-absorbing, properties characteristic of the cartilage. Moreover, the known artificial devices have not proven able to withstand the forces inherent to routine knee joint function.
In an attempt to overcome the problems associated with the above techniques, osteochondral transplantation, also known as “mosaicplasty” has been used to repair articular cartilage. This procedure involves removing injured tissue from the articular defect and drilling openings such as, for example, cylindrical holes in the base of the defect and underlying bone. Osteochondral plugs such as, for example, cylindrically shaped osteochondral plugs of healthy cartilage and bone, are obtained from another area of the patient, typically from a lower-bearing region of the joint under repair, or from a donor patient, and are implanted in the drilled holes. (The term “autograft” refers to tissue or cells which originate with or are derived from the recipient, whereas the term “allograft” refers to cells and tissue which originate with, or are derived from, a donor of the same species as the recipient, in this case, another human.)
However, one or more problems or issues may arise in connection with an osteochondral transplantation procedure. For example, multiple instruments may be required during the osteochondral transplantation, with one or more instruments being used for each step in the procedure, thereby possibly increasing the time spent during, and the overall costs and/or complexity of, the procedure. Moreover, in procedures involving multiple osteochondral plugs, the one or more sites containing healthy bone and cartilage may need to be revisited several times, from the articular defect, in order to complete the transplantation, thereby also possibly increasing the time spent during, and the overall costs and/or complexity of, the procedure. Also, during the impacting of one or more osteochondral plugs, the operator may not be able to adequately determine the amount of force that is being applied to each of the osteochondral plugs, and therefore may not be able to know whether enough force has been applied to suitably impact each of the osteochondral plugs, or whether too great a force is being applied against the osteochondral plugs during the impacting.
In view of all of the above and/or other considerations, what is needed is an apparatus and/or method for manipulating one or more osteochondral plugs, including, but not limited to, extracting and/or implanting the one or more osteochondral plugs, that overcomes one or more of the above-described problems, among other problems.